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目的了解胆道感染时胆汁中致病菌菌群及其对抗生素敏感性的变化,为临床选择用药提供参考和依据。方法将2002年1月至2003年12月培养阳性的264例胆汁标本323株病原菌及药敏结果进行统计分析。结果323株细菌中包含了52种细菌,其中革兰阴性杆菌占594%,革兰阳性球菌占406%。排列前6位的细菌依次为肠球菌220%,大肠埃希菌195%,克雷白菌属118%,葡萄球菌属108%,假单孢菌属87%,肠杆菌属84%。59例混合感染中,大肠埃希菌和铜绿假单孢菌各占12例和10例。细菌对青霉素类、头孢类、喹诺酮类、大环内酯类抗生素敏感性普遍下降,对亚胺培南、美罗培南、万古霉素、替考拉宁仍保持相当高的敏感率。阿米卡星对细菌敏感性也较高,尤其对铜绿假单孢菌有效率仍达687%。结论胆道感染致病菌菌群不断在改变,细菌数量和种类在增加,其对药物敏感性普遍下降;治疗胆道感染应动态监测菌群和药物敏感性的变化及合理应用抗生素。

Study on the changes of biliary bacteria and their sensitivity to antibiotics

Objective To study the changes of biliary bacteria and their sensitivity to antibiotics.Methods The data of 323 strains of aerobes found in 264 patients with positive bile culture from January 2002 to December 2003 and their sensitivity to antibiotics were statistically analyzed.Results The 323 strains of aerobes belonged to 52 species:Gram negative bacteria accounted for 59.4% and Gram positive cocci accounted for 40.6%.The leading six bacteria detected were Enterococcus,Escherichia,Klebsiella,Staphylococcus,Pseudomonas aeruginosa and Enterobacter.Among 59 cases of mixed infection,12 cases and 10 cases were infected with Escherichia and Pseudomonas aeruginosa respectively.The bacteria were highly resistant to penicillin,cephalosporins and quinolones.However,they were highly sensitive to imipenem,meropenem,vancomycin and teicoplanin.The bacteria kept high sensitivity to amikacin.Especially 68.7% of Pseudomonas aeruginosa were sensitive to it.Conclusion Types of pathogens of biliary tract infection as well as their antibiotic resistance are increasing,so it is important to keep on detecting the changes of biliary bacteria and their sensitivity to antibiotics and using them properly.